Med Surg Exam 3 Test Bank questions with answers
A patient is admitted to the ED complaining of severe abdominal pain, stating that he has been vomiting
coffee-ground like emesis. The patient is diagnosed with a perforated gastric ulcer and is informed that
he needs surgery. When can the patient most likely anticipate that the surgery will be scheduled?
A) Within 24 hours
B) Within the next week
C) Without delay because the bleed is emergent
D) As soon as all the days elective surgeries have been completed - CORRECT ANSWER-C
Emergency surgeries are unplanned and occur with little time for preparation for the patient or the
perioperative team. An active bleed is considered an emergency, and the patient requires immediate
attention because the disorder may be life threatening. The surgery would not likely be deferred until
after elective surgeries have been completed.
The nurse is performing a preoperative assessment on a patient going to surgery. The patient informs the
nurse that he drinks approximately two bottles of wine each day and has for the last several years. What
postoperative difficulties can the nurse anticipate for this patient?
A) Alcohol withdrawal syndrome immediately following surgery
B) Alcohol withdrawal syndrome 2 to 4 days after his last alcohol drink
C) Alcohol withdrawal syndrome upon administration of general anesthesia
D) Alcohol withdrawal syndrome 1 week after his last alcohol drink - CORRECT ANSWER-B
Alcohol withdrawal syndrome may be anticipated between 48 and 96 hours after alcohol withdrawal and
is associated with a significant mortality rate when it occurs postoperatively.
In anticipation of a patients scheduled surgery, the nurse is teaching her to perform deep breathing and
coughing to use postoperatively. What action should the nurse teach the patient?
A) The patient should take three deep breaths and cough hard three times, at least every 15 minutes for
the immediately postoperative period.
,B) The patient should take three deep breaths and exhale forcefully and then take a quick short breath
and cough from deep in the lungs.
C) The patient should take a deep breath in through the mouth and exhale through the mouth, take a
short breath, and cough from deep in the lungs.
D) The patient should rapidly inhale, hold for 30 seconds or as long as possible, and exhale slowly. -
CORRECT ANSWER-C
The patient assumes a sitting position to enhance lung expansion. The nurse then demonstrates how to
take a deep, slow breath and how to exhale slowly. After practicing deep breathing several times, the
patient is instructed to breathe deeply, exhale through the mouth, take a short breath, and cough from
deep in the lungs.
The nurse is preparing a patient for surgery prior to her hysterectomy without oophorectomy. The nurse
is witnessing the patients signature on a consent form. Which comment by the patient would best
indicate informed consent?
A) I know Ill be fine because the physician said he has done this procedure hundreds of times.
B) I know Ill have pain after the surgery but theyll do their best to keep it to a minimum.
C) The physician is going to remove my uterus and told me about the risk of bleeding.
D) Because the physician isnt taking my ovaries, Ill still be able to have children. - CORRECT ANSWER-C
The surgeon must inform the patient of the benefits, alternatives, possible risks, complications,
disfigurement, disability, and removal of body parts as well as what to expect in the early and late
postoperative periods. The nurse clarifies the information provided, and, if the patient requests
additional
information, the nurse notifies the physician. In the correct response, the patient is able to tell the nurse
what will occur during the procedure and the associated risks. This indicates the patient has a sufficient
understanding of the procedure to provide informed consent. Clarification of information given may be
necessary, but no additional information should be given. The other listed statements do not reflect an
understanding of the surgery to be performed.
The nurse is planning patient teaching for a patient who is scheduled for an open hemicolectomy. The
,nurse intends to address the topics of incision splinting and leg exercises during this teaching session.
When is the best time for the nurse to provide teaching?
A) Upon the patients admission to the postanesthesia care unit (PACU)
B) When the patient returns from the PACU
C) During the intraoperative period
D) As soon as possible before the surgical procedure - CORRECT ANSWER-D
Teaching is most effective when provided before surgery. Preoperative teaching is initiated as soon as
possible, beginning in the physicians office, clinic, or at the time of preadmission testing when diagnostic
tests are performed. Upon admission to the PACU, the patient is usually drowsy, making this
an inopportune time for teaching. Upon the patients return from the PACU, the patient may remain
drowsy. During the intraoperative period, anesthesia alters the patients mental status, rendering
teaching
ineffective.
The nurse is caring for a hospice patient who is scheduled for a surgical procedure to reduce the size of
his spinal tumor in an effort to relieve his pain. The nurse should plan this patient care with the
knowledge that his surgical procedure is classified as which of the following?
A) Diagnostic
B) Laparoscopic
C) Curative
D) Palliative - CORRECT ANSWER-D
A patient on hospice will undergo a surgical procedure only for palliative care to reduce pain, but it is
not curative. The reduction of tumor size to relieve pain is considered a palliative procedure. A
laparoscopic procedure is a type of surgery that is utilized for diagnostic purposes or for repair. The
excision of a tumor is classified as curative. This patient is not having the tumor removed, only the size
reduced.
A nurse is providing preoperative teaching to a patient who will soon undergo a cardiac bypass. The
, nurses teaching plan includes exercises of the extremities. What is the purpose of teaching a patient leg
exercises prior to surgery?
A) Leg exercises increase the patients muscle mass postoperatively.
B) Leg exercises improve circulation and prevent venous thrombosis.
C) Leg exercises help to prevent pressure sores to the sacrum and heels.
D) Leg exercise help increase the patients level of consciousness after surgery. - CORRECT ANSWER-B
Exercise of the extremities includes extension and flexion of the knee and hip joints (similar to bicycle
riding while lying on the side) unless contraindicated by type of surgical procedure (e.g., hip
replacement). When the patient does leg exercises postoperatively, circulation is increased, which helps
to prevent blood clots from forming. Leg exercises do not prevent pressure sores to the sacrum, or
increase the patients level of consciousness. Leg exercises have the potential to increase strength and
mobility, but are unlikely to make a change to muscle mass in the short term.
During the care of a preoperative patient, the nurse has given the patient a preoperative
benzodiazepine. The patient is now requesting to void. What action should the nurse take?
A) Assist the patient to the bathroom.
B) Offer the patient a bedpan or urinal.
C) Wait until the patient gets to the operating room and is catheterized.
D) Have the patient go to the bathroom. - CORRECT ANSWER-B
If a preanesthetic medication is administered, the patient is kept in bed with the side rails raised because
the medication can cause lightheadedness or drowsiness. If a patient needs to void following
administration of a sedative, the nurse should offer the patient a urinal. The patient should not get out
of
bed because of the potential for lightheadedness.
The nurse is preparing a patient for surgery. The patient states that she is very nervous and really does
not understand what the surgical procedure is for or how it will be performed. What is the most
appropriate nursing action for the nurse to take?
A patient is admitted to the ED complaining of severe abdominal pain, stating that he has been vomiting
coffee-ground like emesis. The patient is diagnosed with a perforated gastric ulcer and is informed that
he needs surgery. When can the patient most likely anticipate that the surgery will be scheduled?
A) Within 24 hours
B) Within the next week
C) Without delay because the bleed is emergent
D) As soon as all the days elective surgeries have been completed - CORRECT ANSWER-C
Emergency surgeries are unplanned and occur with little time for preparation for the patient or the
perioperative team. An active bleed is considered an emergency, and the patient requires immediate
attention because the disorder may be life threatening. The surgery would not likely be deferred until
after elective surgeries have been completed.
The nurse is performing a preoperative assessment on a patient going to surgery. The patient informs the
nurse that he drinks approximately two bottles of wine each day and has for the last several years. What
postoperative difficulties can the nurse anticipate for this patient?
A) Alcohol withdrawal syndrome immediately following surgery
B) Alcohol withdrawal syndrome 2 to 4 days after his last alcohol drink
C) Alcohol withdrawal syndrome upon administration of general anesthesia
D) Alcohol withdrawal syndrome 1 week after his last alcohol drink - CORRECT ANSWER-B
Alcohol withdrawal syndrome may be anticipated between 48 and 96 hours after alcohol withdrawal and
is associated with a significant mortality rate when it occurs postoperatively.
In anticipation of a patients scheduled surgery, the nurse is teaching her to perform deep breathing and
coughing to use postoperatively. What action should the nurse teach the patient?
A) The patient should take three deep breaths and cough hard three times, at least every 15 minutes for
the immediately postoperative period.
,B) The patient should take three deep breaths and exhale forcefully and then take a quick short breath
and cough from deep in the lungs.
C) The patient should take a deep breath in through the mouth and exhale through the mouth, take a
short breath, and cough from deep in the lungs.
D) The patient should rapidly inhale, hold for 30 seconds or as long as possible, and exhale slowly. -
CORRECT ANSWER-C
The patient assumes a sitting position to enhance lung expansion. The nurse then demonstrates how to
take a deep, slow breath and how to exhale slowly. After practicing deep breathing several times, the
patient is instructed to breathe deeply, exhale through the mouth, take a short breath, and cough from
deep in the lungs.
The nurse is preparing a patient for surgery prior to her hysterectomy without oophorectomy. The nurse
is witnessing the patients signature on a consent form. Which comment by the patient would best
indicate informed consent?
A) I know Ill be fine because the physician said he has done this procedure hundreds of times.
B) I know Ill have pain after the surgery but theyll do their best to keep it to a minimum.
C) The physician is going to remove my uterus and told me about the risk of bleeding.
D) Because the physician isnt taking my ovaries, Ill still be able to have children. - CORRECT ANSWER-C
The surgeon must inform the patient of the benefits, alternatives, possible risks, complications,
disfigurement, disability, and removal of body parts as well as what to expect in the early and late
postoperative periods. The nurse clarifies the information provided, and, if the patient requests
additional
information, the nurse notifies the physician. In the correct response, the patient is able to tell the nurse
what will occur during the procedure and the associated risks. This indicates the patient has a sufficient
understanding of the procedure to provide informed consent. Clarification of information given may be
necessary, but no additional information should be given. The other listed statements do not reflect an
understanding of the surgery to be performed.
The nurse is planning patient teaching for a patient who is scheduled for an open hemicolectomy. The
,nurse intends to address the topics of incision splinting and leg exercises during this teaching session.
When is the best time for the nurse to provide teaching?
A) Upon the patients admission to the postanesthesia care unit (PACU)
B) When the patient returns from the PACU
C) During the intraoperative period
D) As soon as possible before the surgical procedure - CORRECT ANSWER-D
Teaching is most effective when provided before surgery. Preoperative teaching is initiated as soon as
possible, beginning in the physicians office, clinic, or at the time of preadmission testing when diagnostic
tests are performed. Upon admission to the PACU, the patient is usually drowsy, making this
an inopportune time for teaching. Upon the patients return from the PACU, the patient may remain
drowsy. During the intraoperative period, anesthesia alters the patients mental status, rendering
teaching
ineffective.
The nurse is caring for a hospice patient who is scheduled for a surgical procedure to reduce the size of
his spinal tumor in an effort to relieve his pain. The nurse should plan this patient care with the
knowledge that his surgical procedure is classified as which of the following?
A) Diagnostic
B) Laparoscopic
C) Curative
D) Palliative - CORRECT ANSWER-D
A patient on hospice will undergo a surgical procedure only for palliative care to reduce pain, but it is
not curative. The reduction of tumor size to relieve pain is considered a palliative procedure. A
laparoscopic procedure is a type of surgery that is utilized for diagnostic purposes or for repair. The
excision of a tumor is classified as curative. This patient is not having the tumor removed, only the size
reduced.
A nurse is providing preoperative teaching to a patient who will soon undergo a cardiac bypass. The
, nurses teaching plan includes exercises of the extremities. What is the purpose of teaching a patient leg
exercises prior to surgery?
A) Leg exercises increase the patients muscle mass postoperatively.
B) Leg exercises improve circulation and prevent venous thrombosis.
C) Leg exercises help to prevent pressure sores to the sacrum and heels.
D) Leg exercise help increase the patients level of consciousness after surgery. - CORRECT ANSWER-B
Exercise of the extremities includes extension and flexion of the knee and hip joints (similar to bicycle
riding while lying on the side) unless contraindicated by type of surgical procedure (e.g., hip
replacement). When the patient does leg exercises postoperatively, circulation is increased, which helps
to prevent blood clots from forming. Leg exercises do not prevent pressure sores to the sacrum, or
increase the patients level of consciousness. Leg exercises have the potential to increase strength and
mobility, but are unlikely to make a change to muscle mass in the short term.
During the care of a preoperative patient, the nurse has given the patient a preoperative
benzodiazepine. The patient is now requesting to void. What action should the nurse take?
A) Assist the patient to the bathroom.
B) Offer the patient a bedpan or urinal.
C) Wait until the patient gets to the operating room and is catheterized.
D) Have the patient go to the bathroom. - CORRECT ANSWER-B
If a preanesthetic medication is administered, the patient is kept in bed with the side rails raised because
the medication can cause lightheadedness or drowsiness. If a patient needs to void following
administration of a sedative, the nurse should offer the patient a urinal. The patient should not get out
of
bed because of the potential for lightheadedness.
The nurse is preparing a patient for surgery. The patient states that she is very nervous and really does
not understand what the surgical procedure is for or how it will be performed. What is the most
appropriate nursing action for the nurse to take?
